Volume 25, Issue 1 (Avicenna Journal of Clinical Medicine - Spring 2018)                   Avicenna J Clin Med 2018, 25(1): 12-19 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Mosalrezaei A, Valizade Hasanloei M A, Kahoorian A. Comparison of the Effects of Trinitroglycerin Infusion and Labetalol in the Management of Acute Arterial Hypertension in Intracerebral Hemorrhage Patients Admitted to an Intensive Care Unit. Avicenna J Clin Med 2018; 25 (1) :12-19
URL: http://sjh.umsha.ac.ir/article-1-1693-en.html
1- Assistant Professor, Department of Neurology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
2- Associate Professor, Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran , aminvalizade@yahoo.com
3- General Practitioner, Uremia University of Medical Sciences, Urmia, Iran
Abstract:   (10996 Views)
Background and Objective: Intracerebral hemorrhage (ICH) is caused by bleeding within brain parenchyma and the formation of regional hematoma. In this study, we compared the effects of trinitroglycerin (TNG) and labetalol in controlling arterial hypertension in patients with ICH admitted to the intensive care unit (ICU) of Imam Hospital in Urmia city, Iran.
Materials and Methods: We selected 54 patients, 20 of whom were treated with labetalol (preferred treatment) and 34 received TNG serum infusion. Demographic information, disease severity (using ICH score, Acute Physiologic Assessment and Chronic Health Evaluation II [APACHEII] score, and Glasgow Coma Scale [GCS]), and the initial size of the hematoma (by computed tomography scan imaging) were recorded. Systolic and diastolic blood pressure were measured every one hour for 24 hours. The data were analyzed using the appropriate statistical tests in SPSS, version 20.
Results: The mean GCS scores in the labetalol and TNG groups were 10.45±4.11 and 10.17±4.44, respectively (P=0.82). At the time of detection, the mean amount of hematoma in the labetalol group was 65.15±24.2 cc, and in TNG group, it was 63.16±28.1 cc (P=0.66). The mean reduction in the size of hematoma after 24 hours in the labetalol and TNG groups was 41.3±16 cc and 45±17.4 cc, respectively (P=0.95). Hypotension was observed in 10% of the labetalol group and in 17.4% of the TNG group (P=0.01). Changes in mean systolic and diastolic blood pressure were not significantly different between the two groups during 24 hours (P=0.83 and P=0.99, respectively).
Conclusion: Both drugs are effective in reducing blood pressure and no significant differences were observed between the two drugs in this regard.
Full-Text [PDF 681 kb]   (1495 Downloads)    
Type of Study: Original |

References
1. Hemphill JC 3rd, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, et al. Guidelines for the management of spontaneous intracerebral hemorrhage a guideline for healthcare professionals from the American heart association/American stroke association. Stroke. 2015;46(7):2032-60. [DOI] [PubMed]
2. Ropper AH, Samuels MA, Klein JP. Craniocerebral trauma. In: Ropper AH, editor. Adams and Victor`s principle of neurology. 10th ed. New York:McGraw-Hill; 2005.
3. Santalucia P. Intracerebral hemorrhage: medical treatment. Neurol Sci. 2008;29(2):S271-3. [DOI] [PubMed]
4. Sacco S, Marini C, Carolei A. Medical treatment of intracerebral hemorrhage. Neurol Sci. 2004;25(Suppl 1):S6-9. [DOI] [PubMed]
5. Zazulia AR, Diringer MN, Videen TO, Adams RE, Yundt K, Aiyagari V, et al. Hypoperfusion without ischemia surrounding acute intracerebral hemorrhage. J Cereb Blood Flow Metab. 2001;21(7):804-10. [DOI] [PubMed]
6. Yazbeck MF, Rincon F, Mayer SA. Interacere-bralhemorrhage. The neuro ICU book.New York:McGraw Hill; 2012. P. 35-51.
7. Liu-Deryke X, Janisse J, Coplin WM, Parker D Jr. Norris G Rhoney DH. A comparison of nicardipine and labetalol for acute hypertension management following stroke. Neurocrit Care. 2008;9(2):167-76. [DOI] [PubMed]
8. Anderson CS, Heeley E, Huang Y, Wang J, Stapf C,Delcourt C, et al. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage. N Engl J Med. 2013;368(25):2355-65. [DOI] [PubMed]
9. Ortega-Gutierrez S, Thomas J, Reccius A, Agarwal S, Lantigua H, Li M, et al. Effectiveness and safety of nicardipine and labetalol infusion for blood pressure management in patients with intracerebral and subarachnoid hemorrhage. Neurocrit Care. 2013;18(1):13-9. [DOI] [PubMed]
10. Woloszyn AV, McAllen KJ, Figueroa BE,DeShane RS, Barletta JF. Retrospective evaluation of nicardipine versus labetalol for blood pressure control in aneurysmal subarachnoid hemorrhage. Neurocrit Care. 2012;16(3):376-80. [DOI] [PubMed]
11. Victor M, Ropper AH. Cerebrovascular disease. In: Victor M, Ropper AH, editors. Adams and Victor’s principles of neurology. 7thed. New York: McGraw-Hill; 2001. P. 821-924.
12. Iniesta JA,Corral J, González-Conejero R, Piqueras C, Vicente V.Polymorphisms of platelet adhesive receptors: do they play a role in primary ICH. Cerebrovasc Dis. 2003;15(1-2):51-5. [DOI] [PubMed]
13. Jørgensen HS, Nakayama H, Christensen HR, Raaschou HO, Kampmann JP, Olsen TS.Blood pressure in acute stroke. The Copenhagen Stroke Study. Cerebrovascular Dis. 2002;13(3):204-9. [DOI] [PubMed]
14. Bae HG, Jeong DS, Doh JW, Lee KS, Yun IG, Byun BJ. Recurrence of bleeding in patients with hypertensive ICH. Cerebrovascular Dis. 1999;9(2):102-8. [DOI]
15. Donahoe M. Very high systemic arterial blood pressure. In: Vincent JL, Abraham E, Moore FA, Kochanek PM, Fink MP, editors.Text book of critical care. 7th ed. New York: Elsevier; 2017. P. 19-23.

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Avicenna Journal of Clinical Medicine

Designed & Developed by : Yektaweb